Cyclosporine-A Induced Gingival Overgrowth

Background. The link between the gingival overgrowth and cyclosporine pharmacokinetical variables, especially cyclosporine doses which appear to act as stimulator of the gingival proliferative changes, presents a field of interest of large number of researches. The existence of undefined association and/or interaction between the cyclosporine and periodontal variables, could be responsible for this type of gingival overgrowth. The aim of this study was to examine the correlation between the degree of gingival overgrowth, daily doses of cyclosporine A and parodontal parameters. Methods. 120 patients with renal transplants were included in this examination. The cohort was divided into a four groups according to the daily dose of cyclosporine (100, 125, 150, 175 mg). The degree of gingival overgrowth (GOI) was investigated, using a MacGaw index. The plaque index (PI), apical migration, total daily doses of cyclosporine and plasma concentration, was recorded for various groups and a prospective longitudinal follow up was conducted. Results. Statistically significant correlation was found between GOI and cyclosporine dose ( =0,3; p< 0,01) and also with dental plaque ( = 0,6; p<0,01), gingival inflammation ( =0,3; p<0,01) and lost attachment ( = 0,1; p<0,05). The lost attachment varied significantly between groups, (p<0,05). Gingival inflammation index (GII) also differed among groups with different dose (p<0,01). Our findings showed differences in gingival overgrowth index between groups (p< 0,05). Conclusions. Our results show a positive correlation between gingival overgrowth and pharmacological parameters, especially the high doses (above 175 mg) of cyclosporine and also with parodontal parameters which lead to parodontal destructions. Additionally, we underlined the effect of local factors as a cofactor in the development of this side effect.